Discussion of public health and health care policy, from a public health perspective. The U.S. spends more on medical services than any other country, but we get less for it. Major reasons include lack of universal access, unequal treatment, and underinvestment in public health and social welfare. We will critically examine the economics, politics and sociology of health and illness in the U.S. and the world.

Tuesday, October 20, 2009

Safety, cost, and justice

A commenter suggests that we will not have a safer food supply unless we are willing to accept higher food prices. I'm not sure this follows. Obviously some money would have to be spent to improve food safety, by somebody, but the policy equation is not safer food = more expensive food.

I don't know that anyone has tried to calculate how much, if anything, it adds to the cost of specific foods to handle them safely, but it can't be very much. After all, the vast majority of growers, processors, distributors and retailers manage to sell food at competitive prices without poisoning anybody. Conversely, if you do poison people and get caught, it could cost you a whole lot in lawsuits, enforced shutdowns, even permanent extinction as a business. Any food-related business has to invest in safe handling, the issue is really whether they exercise diligence, which is probably not very much related to spending money.

Such relevant expertise as I have comes from health care safety improvement, but I expect it's applicable. The Institute of Medicine famously issued a report in 1999 entitled To Err is Human, which reviewed the nature and extent of medical errors and solutions. Their central conclusion can be found in this paragraph:

Health care organizations must develop a “culture of safety” such that their workforce and processes are focused on improving the reliability and safety of care for patients. Safety should be an explicit organizational goal that is demonstrated by strong leadership on the part of clinicians, executives, and governing bodies. This will mean incorporating a variety of well-understood safety principles, such as designing jobs and working conditions for safety; standardizing and simplifying equipment, supplies, and processes; and enabling care providers to avoid reliance on memory. Systems for continuously monitoring patient safety also must be created and adequately funded.

While it does assert that systems must be funded, that does not necessarily imply an increase in the net cost of providing health care. Standardizing and simplifying, and avoiding reliance on memory, can save money. Health care organizations increasingly are being brought under outside scrutiny to assure patient safety, by funders, state departments of health, and accrediting organizations. But nobody complains about the cost or claims that this adds to the cost of health care. Presumably it reduces it in the long run, since it costs an awful lot when you amputate the wrong leg or give somebody a drug overdose.

I expect the same is true for the food industry. What is needed is accountability, and that may require some public spending -- i.e., taxpayers' money -- to pay for more extensive and effective inspections. But it will be a very small amount in the overall picture of government spending. I think most people will think it is well worth it.

Finally, although libertarians have a reflexive aversion to intrusive government, the truth is that assuring food safety will increase our individual liberty, not constrain it. I want to be free to buy food where and when I will with confidence that it won't make me sick or kill me. Depriving me of that confidence and opportunity makes me less free. Is it worth a few cents in taxes? You betcha.

2 comments:

Much of it could be eliminated just by smaller batch processing, which wouldn't increase costs much AND would make recalls much easier/cheaper. The problem comes in the large factory farms which are too big, and mixing of ingredients from too many sources. The industry needs far more traceability along with better handling and processing procedures.

There is no need for the CEOs and owners to be making multi-million dollar salaries off of providing food to the rest of us, either. They can expend some of their wealth to treat workers better, take care of their health, and get food to us safely.

Food, in the west, and elsewhere btw, is extremely ‘safe’, as compared to 50, 100, or more years ago. It is safe in the sense that it will not infect you or make you ill, except in some extremely rare circumstances. Compared to car accidents, accidents at work, sport accidents, guns in the home, it is a non starter. Sure, there is always room for improvement.

Many, however, would argue that food, first in the US, second in the rest o the West (we always catch up) is somehow unhealthy, has lead to obesity as a first disaster. Corn syrup and all that. Fast food. And so on.

The industries that sell that ‘crap’ (and other ‘healthy’ products as well) are massively subsidized by the Gvmt - the tax payer. Big agri biz lives off direct payments. In the US. In the EU.

Were one to remove the subsidies, and return to somewhat more ‘local’, ‘bio’, farming, with many small holders, less industrial transformation, conditioning, less transport over long distance, etc. - say the green dream - the price of food would immediately be multiplied by at least 3, probably more. Is that ‘safer’ food? In the sense of more healthy for humans in the long run? I would guess so, e.g. cooking your own winter root veggies and forsaking frozen pizza (made from left over grains, pork fat, and flavors) and disgusting cookies, yes. So perhaps the original poster’s argument is of interest.